The Latent Phase: Navigating the Midwifery Certification Exam

Every once in a while, my emotions take over. The
daily grind outweighs the beauty of individual interactions, and I (silently,
or actually) yell out, “I just want to be a midwife!”

Well, guess how that
happens? Every midwife first takes the certification exam.

There is the rational
preparation of studying, practice questions, a good night’s sleep, and
maintaining one’s normal routine the morning of the exam. Perhaps the
difference with the certification exam is that for so many, midwifery became
the ultimate, the second career long aspired – or maybe it’s the absolute
certainty of an upcoming long career of beautiful work. This exam feels,
emotionally and logistically, like far more of a lifetime event than other
exams.

Silver lining of this
whole thing? Each student midwife has already studied for this exam with each
moment caring for women, each birth, each day in class or session with an
experienced midwife.

The nagging bits are all
those facts that just won’t stick, the surprises we never learned during school
or years of experience, and the knowledge that, despite all our preparation,
the first year of practice will command continued learning. The exam is only
the beginning of realizing what we don’t know.

Like with labor and
birth, is there comfort in knowing that many before you have travailed, sweated
and grunted, ultimately succeeded, and celebrated afterward? During my exam
preparation, I discovered volumes of information I did not know. On top of
that, the list of “what to study” (also known as the list of “what to know as a
midwife”) seemed positively inhumane. And yet, midwives somehow tap into that
knowledge every day. Despite feeling overwhelmed, each study session began with
a mantra: “I will join the ranks. I will be a midwife.” So, I started to
organize myself. Like a woman in labor, I’m glad my words of comfort are
catching y’all early!

My experience with the exam may be helpful to
some – I am not too far removed from the experience. But I also checked in with
my graduating class and midwives on Facebook and Twitter to find out what
others had to say. I assure everyone currently studying that we recent
graduates send you oodles of positive vibes, memory cells, and intuition. You
can absolutely do this! Below is a list of our collective best advice –
the links are mostly to Amazon for ease of ordering, but always check at your
local bookstore and with your local midwife counterparts to access their
resources!

Practice questions. Hundreds of
them. This is the bread and butter of exam prep, hands down.

If I discovered, in practice
questions or their answer choices, facts or concepts I had not yet
mastered, I created a separate list for “still need to study.”

I rotated continuing to
challenge myself with practice questions, studying information I thought I
already knew, and systematically tackling the “still need to study” list.

Read midwifery memoirs. Those
are LOADED with fantastic wisdom and intuition about what to do in certain
situations. The books I read through during my final semester were Carol
Leonard’s Lady’s Hands, Lion’s Heart and Into These Hands, edited by Geraldine Simkins.

I also loved using my CNM Exam Prep
iPhone app for practice questions on-the-go. The Certified Nurse Midwife
Exam Prep from Upward Mobility is available for the iPhone and
iPad. I used
this in every spare moment.

What did other people say?

“Don’t
get too worked up about the exam, trust that what you've
studied/experienced has, in fact, taught you something, and that you can
think through the problems presented. And take care of yourself while
studying (sleep, good food, exercise)!” Absolutely!

“I studied the Green Book (ACNM Exam Prep Workbook) only.” Friends
with whom I studied had some great information and practice questions from
this book.

Some people also attend the Exam Prep Workshop
at the ACNM Annual Meeting, which can be incredibly helpful. Whether you
are at the beginning or end of your studying, this workshop can give you structure
and strategies to think through questions and answers.

Now,
from this list, how the heck would one ever figure out what books to get, where
to start studying, and how to make sense of it all? Here’s my final pointer: start with what you have. The exam
itself is expensive, so check whether the resources you already have are still
encouraging your own learning before purchasing new resources. If you need new
material and do not already have access to practice questions, consider splitting
a shopping list with classmates and rotating books. Never undervalue the notes,
PowerPoints, and go-to resources you use on the daily.

Get all of the paperwork in order so last-minute
tasks won’t weigh you down close to exam time, when you’ll really be cramming.
Check with your academic program to see when your certification letters will be
submitted, and the earliest date by which you can take the exam; I recommend
taking it as soon as possible after completing your academic program. This
capitalizes not only on the freshness of the information in your mind, but also
advances the timeline by which you can apply for a job and necessary licenses
and begin working as a midwife. Visit the American Midwifery Certification Board (AMCB) website to obtain the full list of requirements before exam time.

Take some deep breaths, reach out to graduates of the
program before you for advice, and seek solace in knowing that midwives before
you have succeeded, and so will you. And if you have exam fatigue one or
multiple times, take a walk to the bathroom! Like with labor, find a mantra you
can grab on to that focuses on the positive:

I can do this! I know
how to care for women and families! I will be a midwife!

For all those midwives who have already taken the exam: we’d love
to hear your tips! Let us know what worked for you during your exam review
process. Leave a comment on this post or the ACNM or Feminist Midwife Facebook
pages to give your feedback!

Stephanie Tillman is a recently-graduated Nurse-Midwife now
practicing full-scope midwifery in the urban United States, at a Federally
Qualified Health Center (FQHC) and as a member of the National Health Service
Corps (NHSC). With a background in global health and experience in
international clinical care, the impact of public health and the broader
profession of midwifery are present in all her thoughts and works. Stephanie's
blog, Feminist Midwife,
discusses issues related to women, health, and care. Find out more at
www.feministmidwife.com and follow her on Twitter at @feministmidwife.

Any opinions expressed in this blog are those of the individual participant(s) and do not necessarily reflect the views of the American College of Nurse-Midwives. ACNM is not responsible for accuracy of any of the information provided by guest bloggers and/or members via the Comments section. We welcome all feedback – including comments, ideas and suggestions. We also welcome civil, friendly debates. However, any and all content that is deemed inflammatory or rude will not be posted.